1. Technical Field
This document relates to devices and methods for harvesting tissue. For example, this document relates to devices and methods for harvesting abdominal wall fascial tissue in a minimally invasive manner.
2. Background Information
Fascia is a sheet or band of fibrous connective tissue that surrounds muscles, groups of muscles, blood vessels, or nerves. Fascia binds some structures together, while permitting others to slide smoothly over each other.
The rectus sheath is formed by the aponeuroses of the transversus abdominis and the external and internal oblique muscles. It contains the rectus abdominis and pyramidalis muscles. Below the rectus sheath are the following layers: (i) transverse fascia, (ii) extraperitoneal fat, and (iii) parietal peritoneum. The transverse fascia is a thin aponeurotic membrane that lies between the inner surface of the transversus abdominis muscle and the extraperitoneal fascia. The transverse fascia forms part of the general layer of fascia lining the abdominal parietes, and is directly continuous with the iliac and pelvic fasciae.
Stress urinary incontinence (SUI) affects 15-60% of women. It is a disorder that affects both young and elderly individuals. A pubovaginal sling is a procedure used to manage urinary incontinence. The procedure involves placing a band of sling material directly under the bladder neck (e.g., proximal urethra) or mid-urethra, which acts as a physical support to prevent bladder neck and urethral descent during physical activity. The sling also may augment the resting urethral closure pressure with increases in intra-abdominal pressure.
In some cases, surgeons use synthetic mesh sling to treat SUI. An alternative is construction of a sling from a piece fascia, such as from a strip of harvested abdominal wall fascia. This advantageously results in an all-natural and autologous sling that does not use any synthetic components. A minimally invasive technique for harvesting abdominal wall fascia would provide benefits to patients who are treated for SUI using the all-natural and autologous sling made of abdominal wall fascia.